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Diabetes: Preventing High Blood Sugar Emergencies

Introduction

High blood sugar (hyperglycemia) in
diabetes occurs when the sugar (glucose) level in the
blood rises above normal. For a person who has diabetes, high blood sugar may
be caused by not getting insulin, missing your diabetes medicine, eating too much food, skipping exercise, or being ill or
stressed.

Unlike low blood sugar, high blood sugar usually develops
slowly over hours or days. Blood sugar levels well above your target range may
make you feel tired and thirsty. If your blood sugar level stays higher than
your target range, your body will adjust to that level. If your blood sugar continues to
rise, your kidneys will produce more urine and you can become
dehydrated. Signs of dehydration include being thirstier than usual and having darker urine than usual. If you become severely dehydrated, you can
go into a coma and possibly die. Over time, high blood sugar damages the eyes,
heart, kidneys, blood vessels, and nerves.

Unless you fail to
notice the symptoms, you usually have time to treat high blood sugar so that
you can prevent an emergency. Three things can help you prevent high blood
sugar problems:

Test your blood sugar often, especially if you
are sick or not following your normal routine. You can see when your blood
sugar is above your target range, even if you don't have symptoms of high blood
sugar (increased thirst, increased urination, and fatigue). Then you can treat
it early.

Call your doctor if you have frequent high blood sugar or
your blood sugar is consistently above your target range. Your medicine may
need to be adjusted or changed.

Drink extra water or
noncaffeinated, nonsugared drinks to prevent dehydration.

High blood sugar

High blood sugar (hyperglycemia)
means that the level of sugar (glucose) in your blood is above your
target range. Symptoms of high blood sugar usually
develop over a period of hours or days.

You may feel tired and
thirsty when your blood sugar is well above your target range. But some
people's bodies adjust to a high level. They may not have obvious
symptoms of high blood sugar until their levels are
very high. So it is important to check your blood sugar often.

If your blood sugar is between 80 milligrams
per deciliter (mg/dL) and 200 mg/dL, you most likely will not have symptoms. If
you do have symptoms, they will most likely be very mild (such as
fatigue).

If your blood sugar is between 200 mg/dL and 350 mg/dL,
you may have mild symptoms of high blood sugar. You may be thirsty and urinate
more often than usual. Some people may not notice any symptoms when their blood
sugar is in this range.

If your blood sugar rises above 350 mg/dL,
you may feel weak and drowsy, have blurred vision, and sometimes you may lose
your appetite. You may not have these symptoms if your body gets used to the
higher blood sugar levels.

If your blood sugar becomes very high,
you can become confused and severely
dehydrated and go into a coma. Very high blood sugar
leads to changes in the chemical processes of the body (metabolism), causing an
emergency.

What causes high blood sugar?

High blood sugar
develops when there is too little insulin or when your body fails to respond
properly to the insulin in your blood. High blood sugar emergencies often
develop because of some condition that may not be obvious, such as a
heart attack, infection, surgery, or pregnancy.

Your blood sugar can rise to an unsafe level when you:

Skip a dose of diabetes medicine, or you don't get enough insulin.

Eat too much
food.

Do not get enough exercise.

Feel a lot of
stress.

Are sick (such as a severe case of the flu) or have an
infection, even if you are not eating a lot of food.

Symptoms of a high blood sugar emergency
usually develop over a period of hours or days. Unless you fail to notice the
symptoms, you usually have time to get early treatment. A high blood sugar
emergency occurs when high blood sugar levels lead to severe dehydration and
changes in the normal body processes (metabolism).

Symptoms of a high blood sugar emergency
usually develop over a period of hours or days. Unless you fail to notice the
symptoms, you usually have time to get early treatment. A high blood sugar
emergency occurs when high blood sugar levels lead to severe dehydration and
changes in the normal body processes (metabolism).

High blood
sugar levels that are somewhat higher than your
target range may cause symptoms such as increased
thirst and increased urination. If early high blood sugar is not treated, the
level may continue to rise very high. This can be a life-threatening
situation.

When your blood sugar level rises above 200 mg/dL, your
kidneys will eliminate some of the extra sugar through your urine. Along with
sugar, the kidneys release large amounts of fluid, which causes increased
urination. If your blood sugar level continues to rise and you do not drink
enough liquids to replace the lost fluids, you can become
dehydrated. Dehydration can lead to a high blood sugar
emergency.

Both of the following high blood sugar emergencies can
become life-threatening:

If you have type 2 diabetes, you are at risk
for a high blood sugar emergency called a
hyperosmolar state. A hyperosmolar state can develop
if your blood sugar is consistently very high, such as above 600 mg/dL, and you
become dehydrated. It is easy to overlook early symptoms of a hyperosmolar
state. Typically, you have increased urination for several days before a
hyperosmolar state develops. You may not always have increased thirst and may
become dehydrated from not drinking enough liquids.

If you have
type 1 diabetes, you are at risk for a condition called
diabetic ketoacidosis (DKA). People with type 2
diabetes whose bodies produce little or no insulin are also at risk for DKA. DKA can occur if your blood sugar levels are consistently high, such as above
250 mg/dL, and you become dehydrated. In ketoacidosis, your body burns protein
and fat rather than sugar for energy, causing acids and
ketones to build up in your blood. These ketones can
be partially released into your urine. If ketoacidosis develops, you need
emergency care immediately to keep the condition from getting worse.

High blood sugar emergencies often develop because of some
condition that may not be obvious, such as a heart attack,
infection, surgery, pregnancy, or undiagnosed diabetes.

Test Your Knowledge

I have type 1 diabetes and my body produces little or
no insulin. A high blood sugar emergency can occur if my blood sugar level
continues to rise above 250 mg/dL.

If you have type 1 diabetes, your body produces
little or no insulin. A high blood sugar emergency (ketoacidosis) can occur if
your blood sugar level continues to rise above 250 mg/dL and you become
dehydrated. If ketoacidosis develops, you need emergency care immediately to
keep the condition from getting worse.

If you have type 1 diabetes, your body produces
little or no insulin. A high blood sugar emergency (ketoacidosis) can occur if
your blood sugar level continues to rise above 250 mg/dL and you become
dehydrated. If ketoacidosis develops, you need emergency care immediately to
keep the condition from getting worse.

I have type 2 diabetes. A high blood sugar emergency
can occur if my blood sugar level rises very high, such as above 600
mg/dL.

If you have type 2 diabetes, you are at risk
for developing a high blood sugar emergency. If your blood sugar levels are
consistently very high, such as above 600 mg/dL, and you become dehydrated, you
can go into a hyperosmolar state.

If you have type 2 diabetes, you are at risk
for developing a high blood sugar emergency. If your blood sugar levels are
consistently very high, such as above 600 mg/dL, and you become dehydrated, you
can go into a hyperosmolar state.

Treat infections early

Be prepared

Know the
symptoms of high blood sugar, such as increased thirst, increased urination, and fatigue. Post a list of the
symptoms in a place where you can see it often, such as on your refrigerator
door. Add any symptoms you have noticed that may not be on the list. Make sure
other people know the symptoms and what to do in case of an
emergency.

Check your blood sugar at home often, especially if you
are sick or not following your normal routine. If you don't have a home blood
sugar meter (glucose meter), talk with your doctor about getting one. It is
easy to overlook early symptoms, especially if you have increased urination
without increased thirst. Testing your blood sugar at home will help you know
when it is high, even if you do not notice symptoms.

Teach others
(at work and at home) the symptoms of high blood sugar. Teach others to call
911 if you are unconscious or too sick to
check your own blood sugar.

Wear medical identification. Have a
medical alert bracelet or other form of medical jewelry with you at all times.
This is very important in case you are too sick or injured to speak for
yourself. You can find medical identification at a pharmacy or on the
Internet.

Develop a plan. Usually people who take insulin need to
take extra fast-acting insulin when their blood sugar levels are high. Talk
with your doctor about how much to take, depending on your blood sugar level
(sliding scale).

Take your medicines as prescribed. Don't skip
diabetes medicine or insulin doses without first talking with your
doctor.

Treat high blood sugar early

The best way to
prevent high blood sugar emergencies is to treat high blood sugar as soon as
you have symptoms or when your blood sugar is significantly above a target
range (200 mg/dL or higher).

Follow your doctor's instructions for the
steps for dealing with high blood sugar. Post a list
of the steps in a convenient place at home and work. Make sure other people
know what to do if you are unable to treat high blood sugar.

Keep a
record(What is a PDF document?) of high blood sugar levels. Write down your symptoms and how you treated them, and take it with you
when you visit your doctor.

Call your doctor. Let your doctor know if you are having high
blood sugar problems. Your diabetes medicine may need to be adjusted or
changed. If you are taking insulin, your dose of insulin may need to be
increased.

Drink plenty of liquids

If your blood sugar levels
are above your target range, drink extra liquids to replace the fluids lost
through your urine. Water and diet drinks are best. Avoid caffeinated drinks,
alcohol, and soda pop and other liquids that contain a lot of sugar.

Test Your Knowledge

If you have symptoms of mild high blood sugar,
you don't need to call 911. Follow the steps for dealing with
high blood sugar. Treat high blood sugar levels early to prevent an emergency
situation from developing.

If you think you are having symptoms of mild
high blood sugar, follow the steps for dealing with high blood sugar. Treat
high blood sugar levels early to prevent an emergency situation from
developing.

If you think you are having symptoms of mild
high blood sugar, you don't need to take an extra dose of your diabetes medicine. Follow the steps for dealing with high blood sugar.
Treat high blood sugar levels early to prevent an emergency situation from
developing.

Now that you have read this
information, you are ready to start preventing high blood sugar emergencies
effectively.

Talk with your doctor

If you haven't talked with
your doctor about checking your blood sugar at home, do this at your next
visit. Home blood sugar meters (glucose meters) make checking your blood sugar
level at home easy and quick. Using a home blood sugar meter can take the
guesswork out of treating high blood sugar levels.

If you would like more information on diabetes and high
blood sugar, the following resources are available:

Organization

American Diabetes Association (ADA)

1701 North Beauregard Street

Alexandria, VA 22311

Phone:

1-800-DIABETES (1-800-342-2383)

Email:

AskADA@diabetes.org

Web Address:

www.diabetes.org

The American Diabetes Association (ADA) is a national organization
for health professionals and consumers. Almost every state has a local office.
ADA sets the standards for the care of people with diabetes. Its focus is on
research for the prevention and treatment of all types of diabetes. ADA
provides patient and professional education mainly through its publications,
which include the monthly magazine Diabetes Forecast,
books, brochures, cookbooks and meal planning guides, and pamphlets. ADA also
provides information for parents about caring for a child with diabetes.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use.